San Diego-based genetics company to pay nearly $2 million to settle Medicare false claims accusations

City News Service

A San Diego-based genetics testing company has agreed to pay nearly $2 million to settle allegations that it submitted false claims to Medicare for unnecessary testing on prostate cancer patients, federal authorities said Monday.

GenomeDx Biosciences Corp. submitted claims for the Decipher Prostate Cancer Test between September 2015 and June 2017, despite the affected patients not having risk factors necessitating the test, according to the Department of Justice and the U.S. Attorney's Office.

The false claims came to light via two whistle blowers, former GenomeDx employees who authorities say will receive more than $348,000 as part of the settlement proceeds stemming from a civil lawsuit brought against the company.

“As this settlement demonstrates, we are committed to protecting the integrity of the Medicare program and will hold healthcare providers accountable under the False Claims Act when they engage in improper billing,” said Robert Brewer, U.S. Attorney for the Southern District of California.

“This settlement is also another example of our commitment to vigorously investigate cases brought to our attention by whistle blowers,” Brewer said. “We commend the two employees of GenomeDx who had the courage to come forward and work with investigators.”

Christian Schrank, special agent in charge at the Office of Inspector General of the U.S. Department of Health and Human Services, said lab tests and other medical services should only be conducted or provided when medically necessary.

“Whistleblowers play a critical role in keeping entities honest and accountable, and are encouraged to report suspected waste, fraud and abuse by those billing federal healthcare programs,'' Schrank said.